Fusarium Keratitis Update

The Centers for Disease Control and Prevention (CDC) is continuing its
investigation on the multi-state outbreak of Fusarium keratitis
that may be associated with contact lens use.

As of May 5, 2006, CDC has received reports of 102 confirmed cases, 12
possible cases and 81 cases still under investigation from 31 U.S. states
and territories. 65 reports include insufficient evidence to classify them
as cases or carry other non-Fusarium diagnoses. States or
territories with at least 1 confirmed or possible case include: AR, AZ,
CA, CT, FL, GA, IA, IL, KS, KY, LA, MA, MD, MI, MO, NC, ND, NJ, NY, OH,
PA, PR, TN, TX, and VT. States where all cases under investigation
include: IN, MN, NV, OK, OR, and RI.

Not all data are available for all confirmed cases. However, as of May
2, 2006, of the 58 confirmed cases for which CDC has complete data:

56 wear contact lenses

32 reported using any B&L ReNu with MoistureLoc

15 reported using any B&L ReNu MultiPlus

7 reported using any unspecified B&L ReNu

3 reported using any AMO product

3 reported using any Alcon product

* Some cases reported using more than one type of solution and therefore
the solution categories are not mutually exclusive.

(Note: Updated case count numbers will be available on Tuesdays and
Fridays. Updated numbers on solution use and other pertinent exposures
will be available on Tuesdays.)

Summary and Clarifications

In addition, CDC would like to clarify some of the information that has
appeared in a number of recent media stories on the outbreak. The
following information is known related to this outbreak:

Since the first report on this outbreak in the April 10, 2006 Morbidity
and Mortality Weekly Report (MMWR), CDC has noted that patients
have reported using multiple products, including those manufactured
by Bausch & Lomb, Alcon, and Advanced Medical Optics, Inc.

At this point, it is too early in the investigation to say whether a
particular product or solution may be responsible for the outbreak.

Throughout the investigation, the proportion of patients who reported
using Bausch & Lomb’s ReNu with MoistureLoc has remained relatively
consistent, at around 50-60 percent of confirmed cases.

ReNu with MoistureLoc was used by approximately 2.3 million contact
lens wearers in the United States, while MultiPlus was used by nearly
11 million contact lens wearers (branded or private label).

Fusarium keratitis is naturally occurring disease in the United
States. It is not a disease that healthcare providers must report so it
is unclear how many cases occur each year in the United States.

Disease outbreaks and increased media coverage often raise awareness
about particular infections, which, in turn, may 1) increase reports of
a disease and 2) result in additional information being identified and
collected. Thus, it is possible that some of the cases currently
being investigated represent infection which might normally occur and,
as a result, are not related to the outbreak.

CDC is continuing its investigation into identifying whether there are
specific factors that may have placed people at risk for developing fungal
keratitis, including hygiene practices, overnight contact lens wear and
specific solutions used. The CDC will provide more information as it becomes
available.